The burden of acute pancreatitis on COVID-19 in the United States

Hunza Chaudhry; Aalam Sohal; Isha Kohli; Dino Dukovic; Raghav Sharma; Piyush Singla; Bing Hu; Devang Prajapati; Juliana Yang

doi:10.20524/aog.2023.0782

The burden of acute pancreatitis on COVID-19 in the United States

Ann Gastroenterol. 2023 Mar-Apr;36(2):208-215. doi: 10.20524/aog.2023.0782. Epub 2023 Feb 3.

Authors

Hunza Chaudhry¹, Aalam Sohal², Isha Kohli³, Dino Dukovic⁴, Raghav Sharma⁵, Piyush Singla⁶, Bing Hu⁷, Devang Prajapati⁸, Juliana Yang⁸

Affiliations

¹ Department of Internal Medicine, University of California, San Francisco, Fresno, CA, USA (Hunza Chaudhry).
² Department of Hepatology, Liver Institute Northwest, Seattle, WA, USA (Aalam Sohal).
³ Department of Public Health, Icahn School of Medicine, Mount Sinai, New York, NY, USA (Isha Kohli).
⁴ Ross University School of Medicine, Barbados, USA (Dino Dukovic).
⁵ Punjab Institute of Medical Sciences, India (Raghav Sharma).
⁶ Dayanand Medical College and Hospital, India (Piyush Singla).
⁷ China West Medical Center, China (Bing Hu).
⁸ Department of Gastroenterology and Hepatology, University of California, San Francisco, Fresno, CA, USA (Devang Prajapati, Juliana Yang).

Abstract

Background: Although SARS-CoV-2 primarily affects the respiratory system, gastrointestinal symptoms were also seen. Our study analyzed the prevalence and impact of acute pancreatitis (AP) on COVID-19 hospitalizations in the United States.

Methods: The 2020 National Inpatient Sample database was used to identify patients with COVID-19. The patients were stratified into 2 groups based on the presence of AP. AP as well as its impact on COVID-19 outcomes were evaluated. The primary outcome was in-hospital mortality. Secondary outcomes were intensive care unit (ICU) admissions, shock, acute kidney injury (AKI), sepsis, length of stay, and total hospitalization charges. Univariate and multivariate logistic/linear regression analyses were performed.

Results: The study population comprised 1,581,585 patients with COVID-19, from which 0.61% of people had AP. Patients with COVID-19 and AP had a higher incidence of sepsis, shock, ICU admissions, and AKI. On multivariate analysis, patients with AP had higher mortality (adjusted odds ratio [aOR] 1.19, 95% confidence interval [CI] 1.03-1.38; P=0.02). We also noted a higher risk of sepsis (aOR 1.22, 95%CI 1.01-1.48; P=0.04), shock (aOR 2.09, 95%CI 1.83-2.40; P<0.001), AKI (aOR 1.79, 95%CI 1.61-1.99; P<0.001), and ICU admissions (aOR 1.56, 95%CI 1.38-1.77; P<0.001). Patients with AP also had a longer length of stay (+2.03 days, 95%CI 1.45-2.60; P<0.001), and higher hospitalization charges ($44,088.41, 95%CI $33,198.41-54,978.41; P<0.001).

Conclusions: Our study revealed that the prevalence of AP in patients with COVID-19 was 0.61%. Although this was not strikingly high, the presence of AP is associated with worse outcomes and higher resource utilization.

Keywords: Acute pancreatitis; COVID-19; pandemic.